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Medicine United Kingdom

Cause and Cure Discovered for a Common Type of High Blood Pressure (scitechdaily.com) 62

Posted by EditorDavid from the you're-so-vein dept.
Researchers at a London-based public research university had already discovered that for 5-10% of people with hypertension, the cause is a gene mutation in their adrenal glands. (The mutation results in excessive production of a hormone called aldosterone.)

But that was only the beginning, according to a new announcement from the university shared by SciTechDaily: Clinicians at Queen Mary University of London and Barts Hospital have identified a gene variant that causes a common type of hypertension (high blood pressure) and a way to cure it, new research published in the journal Nature Genetics shows.

The cause is a tiny benign nodule, present in one-in-twenty people with hypertension. The nodule produces a hormone, aldosterone, that controls how much salt is in the body. The new discovery is a gene variant in some of these nodules which leads to a vast, but intermittent, over-production of the hormone. The gene variant discovered today causes several problems which makes it hard for doctors to diagnose some patients with hypertension. Firstly, the variant affects a protein called CADM1 and stops cells in the body from 'talking' to each other and saying that it is time to stop making aldosterone. The fluctuating release of aldosterone throughout the day is also an issue for doctors, which at its peak causes salt overload and hypertension. This fluctuation explains why patients with the gene variant can elude diagnosis unless they happen to have blood tests at different times of day.

The researchers also discovered that this form of hypertension could be cured by unilateral adrenalectomy — removing one of the two adrenal glands. Following removal, previously severe hypertension despite treatment with multiple drugs disappeared, with no treatment required through many subsequent years of observation.

Fewer than 1% of people with hypertension caused by aldosterone are identified because aldosterone is not routinely measured as a possible cause. The researchers are recommending that aldosterone is measured through a 24-hour urine test rather than one-off blood measurements, which will discover more people living with hypertension but going undiagnosed.
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Cause and Cure Discovered for a Common Type of High Blood Pressure More

Cause and Cure Discovered for a Common Type of High Blood Pressure

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  • Tiny benign module (Score:5, Funny)

    by PPH ( 736903 ) on Sunday June 11, 2023 @03:34PM (#63593624)

    But what if it's compiled into the kernel?

  • I like me salty food.
    But I don't want to die.

    All the reports I see about cutting salt seem to rely on the usual unreliable animal torture and wishy washy stuff and not actual human testing.

    Is there actually any evidence that salt is bad for normal people ( i.e. not people with rare aldosterone or other as-yet-unknown problems ) ?

    • Sounds like something you should be asking your doctor.

    • Yes, there's plenty of evidence that low salt diets lower BP in humans; no "animal torture" or "wishy washy stuff" required. Since we don't regularly test aldosterone, it's possible that salt restriction is more effective in people with this aldosterone disorder.

      https://pubmed.ncbi.nlm.nih.go... [nih.gov]

      • Thanks.

        I didn't check them all, but they look like "Salt helps reduce hypertension".

        But I don't have hypertension.

        Is there any evidence that it is good for me to cut down my salt intake ?

        • "Excessive sodium intake is associated with the development of a variety of comorbidities including hypertension, chronic kidney disease, stroke, and cardiovascular diseases."

          https://pubmed.ncbi.nlm.nih.go... [nih.gov]

          "The purpose of this review was to identify, summarize, and critically appraise studies on dietary salt and health outcomes..."

          https://pubmed.ncbi.nlm.nih.go... [nih.gov]

          "High-salt intake disrupts the gastric mucosal defense barrier, promoting Helicobacter pylori colonization and penetration of other carcinogenic

          • Re: (Score:2)

            by keltor ( 99721 ) *
            Epidemiological studies are absolutely the worst choice to actually "prove" anything. It's used for actual research targeting and should never be used for public health direction. Unfortunately, doctors are not scientists or engineers but more akin to social sciences

            • Re:Is there evidence salt is bad for normal people (Score:4, Interesting)

              by greytree ( 7124971 ) on Sunday June 11, 2023 @05:38PM (#63593818)
              Has anyone ever taken a group of normal, fit people and divided them into high, normal and low salt diets and checked their health after a couple of years ?
              • This! They actually seem to very rarely do things like this. Doing things like this is expensive and troublesome. So, they take some medical database and define a cohort of people who seem to fit some criteria, find some correlation and publish. With limited usefulness, of course.

                • This! They actually seem to very rarely do things like this. Doing things like this is expensive and troublesome. So, they take some medical database and define a cohort of people who seem to fit some criteria, find some correlation and publish. With limited usefulness, of course.

                  You're making a statement unsupported by data. There are plenty of randomized control trials done as well. Yes they are expensive and troublesome because humans can be awful at adhering to study designs. That said, even with epidemiological cohort studies, a lot of statistical work is done to remove confounders and draw conclusions.

                  But here you go...filtered for randomized control trials only (any errors are PubMed's, not mine, I'm not going to sift through every article to do even more work for y'all...)

                  ht [nih.gov]

                  • If something is not supported by data it does not necessary mean that it is not true. Sometimes, it is really difficult to support something. Still it may be correct. May be not, too, yes. One reason why sometimes it is difficult to support something is just because all the funding goes in the direction of supporting something else. If you want to contradict you will not get any money and will be cancelled. Just one example.

                    The first reference from your list, "Sodium Intake and All-Cause Mortality Over 20

                    • No, the stated background is "The relationship between lower sodium intake and mortality remains controversial" which is to say that some folks, like yourself perhaps, continue to try and dispute this. The author's conclusions however are "We found an increased risk of mortality for high-sodium intake and a direct relationship with total mortality, even at the lowest levels of sodium intake."

                      Note, the conclusion is not "the result are unclear" or "we failed to show a clear trend" but rather "we found an inc

                    • You will die if you do not eat any salt. This is quite obvious. So, no need for an advise.

                      These correlations are very misleading. I did not read the entire paper, but there may be hordes of other reasons for increased mortality. For example, people who eat a lot of salt may not care about their health... You will get the increased mortality rate, but not because of the salt.

                      Do you know, that 100% of people who ate cucumbers eventually die? Please stop eating cucumbers.

                      Yes, I do deny the dangers of salt,

                    • Yes, I do deny the dangers of salt, first, because I have not seen a bad effect on myself, second, because it is still controversial, third, because there have not been a 100% clear cut causal evidence, and finally, I am sick and tired of everyone trying to scare everyone else. Everything is good in moderation. Just stop going to the extremes and everything will be alright.

                      This has got to be one of the most ridiculous and both scientifically and medically ignorant things I've ever read. Adding in your prior

                    • OK, I do have some holes in my reasoning. But what about yourself? Can you really keep track of all bad things that can affect your health which have been suggested? This is not sustainable: do not eat salt, it is bad for you, do not eat sugar, it is really bad for you, do not eat sweeteners, they are bad for you, do not eat meat, it is bad for you... This is really ridiculous ... how possibly you can optimize your health when so many "scientists" publish so many negative information? What I do see, though,

                  • Re: (Score:2)

                    by znrt ( 2424692 )

                    I'm not going to sift through every article to do even more work for y'all

                    honestly, i don't know why you even bothered, these guys aren't even interested in your answers, just in nagging at whatever they can find to try and shoot you down. just let them choke on their salty potatoes and popcorn.

                    btw, thanks for the effort but this is really a no-brainer, anyone with a cheap blood pressure monitor can easily check how high salt intake or lack of sleep or exercise drive blood pressure up.

                    • OK, I have a blood pressure monitor and have been using for the last 14 years every morning and writing down the numbers. Nothing of what you mentioned I can confirm. Lack of sleep does not increase blood pressure (at least mine), it does however increase my morning heart rate. Salt intake does not have any effect on the blood pressure I could notice. Lack of exercise is more difficult to measure and it takes long time. But, extra weight has clearly direct effect on the blood pressure and heart rate.

                      Salt h

                    • I take my blood pressure at the same time every day after sitting for 10 minutes before I drink my coffee. I know exactly what effects my BP. In order of biggest to least effect:

                      1. Booze - The day after I drink I typically see my BP skyrocket into stage 2 hypertension.
                      2. Salt - Days with high salt intake I typically see a large jump in BP the following day.
                      3. Red meat - Days I eat red meat typically cause a increase in BP the following day. (could be related to how much I salt red meat)
                      4. Weekends - My BP i

                    • One other interesting fact. The BP pills that were most effective for me are diuretics. Sees like the things that make my BP jump the most also cause water retention. The exception to that seems to be creatine.

                    • Thus, as we see different effects, we can say that BP is affected in multiple ways in multiple people. Therefore, universal "truths" like do not eat salt are probably not as universal as we think. My BP range for these 14 years has been 100-116. Probably, this is why we see different effects here.

                • Re: (Score:2)

                  by ceoyoyo ( 59147 )

                  Most of the heart and stroke epidemiological studies are done on large prospective cohort studies. They take a hundred thousand people or so and ask them to keep a daily journal and come in for regular testing for years or decades.

              • Maybe...but I'm going to guess not. Especially in modern medicine it's hard to pass an Institutional Review Board for a study that subjects individuals to long term (and even short term) interventions that have been frequently shown to be likely harmful. For instance, no one is going to approve a study that has people consume 0, 10g, and 50g of cocaine daily for a year.

              • Re: (Score:2)

                by znrt ( 2424692 )

                Has anyone ever taken a group of normal, fit people

                there are ofc acute cases but hypertension is totally normal, the only way you can evade it is by dying before it becomes a problem for you. just don't get old.

            • But epidemiology is often easier than a randomized control...and we use statistics and normalization to draw relatively good conclusions and exclude confounders.

              That said...it's ridiculous to suggest that other styles or studies are not done. Lots of them in fact...

              "In three prospective randomized controlled trials, practical sodium restriction lowered blood pressure by 8 mm Hg. Such a decrease would lower cardiovascular morbidity by 10% to 15%."

              https://pubmed.ncbi.nlm.nih.go... [nih.gov]

            • Re: (Score:2)

              by ceoyoyo ( 59147 )

              Epidemiologists are scientists. By "epidemiological" I assume you mean "observational." Good observational studies are far from the worst, and can provide reasonable quality evidence. They're not as good as randomized controlled trials, but are you proposing to assign people a daily salt intake for twenty years and then see which of them die?

        • If you don't have hypertension, that's great! But you should be taking steps to keep your blood pressure down below the top range, as it's not hard for something to slip and for your blood pressure to go higher. Besides, as you age, your arterial walls harden, meaning the heart has to work harder, so your blood pressure will go up over time.

          Limiting your salt intake is one (don't go too low--your body needs some salt), but mild to moderate exercise can also help. Just go for a 30-minute walk everyday. Liste

          • Sorry, but that is exactly the sort of wishy-washy advice that I don't want or need.

            Facts.
            I want facts.
            Then *I* can decide what to do about them.
          • Cholesterol you eat does not go onto your blood vessels walls. It gets digested and then your body makes it when needed. Then, it can be deposited in wrong places. But it does not go there from your stomach.
    • Water retention increases BP. If you drink a lot of water to flush salt, you can counteract.

    • Re: (Score:2)

      by keltor ( 99721 ) *
      Some people are sensitive to salt, some are not and there's a wide variety of reasons. https://www.ncbi.nlm.nih.gov/p... [nih.gov] If you are of healthy weight and don't have any outstanding issues, you can probably eat whatever you want.
    • I have been having as much salt as I want all my life and have no issues so far. Salt is really necessary for our bodies, it is strange that it is believed to be harmful... I do believe that salt is not bad for healthy people. Possibly, it can be bad if something is not working properly. As a result those doctors just say it is bad, do not eat it for everybody. Just to be on the safe side. It is really amazing how much they do not really know.

      This development is really great. Totally shows, that it is not

      • All things are harmful to the body when not consumed in moderation. You can kill yourself by consuming water (water-intoxication). Your body needs all sorts of things that in some concentration kills you. It's the dose that makes the poison after all. There are unhealthy levels of salt that could be consumed (and probably are by many Americans) that result in slow damage to the body. This finding doesn't disprove that, it simply shows that normal salt intake can be harmful for people with this mutation.

        I lo

        • I doubt that the kidney failure was caused by salt, though. Was it?

          Some long time ago, when I was a chemistry student I tried to look up LD50 for the salt. And I could not find any. It was said that LD50 for it is unknown, but it was known that having 50g of salt in one time consumption could be harmful. This is where I stopped worrying about how much salt I eat.

          Now, this link suggest that for a 75 kg person (based on rats) the LD50 would be 225g of salt. ...

    • Check out the Andrew Huberman pod on salt. He does a comprehensive survey of the theory and literature.

      Net: avoid processed foods and exercise - otherwise average people don't need to worry. Some people aren't average obviously.

      • Re: (Score:2)

        by Whibla ( 210729 )

        Check out the Andrew Huberman pod on salt. He does a comprehensive survey of the theory and literature.

        Net: avoid processed foods and exercise ...

        And don't forget to use commas or, better yet, semicolons where relevant!

        (or someone else's blood pressure will spike)

    • Salt is absolutely necessary for the human body to function. Low salt diets may be necessary for people with heart conditions, but their issues are a bad heart. If you want to reduce blood pressure, stop eating foods that hurt your body. Foods that raise your blood sugars (way past what they should be), foods full of inflammatory additives, foods that have weird chemicals in them. Foods that require lots of insulin to bring your sugars back down and are also processed cause inflammation in the arteries and

  • Just Lop it Off (Score:4, Interesting)

    by walkerp1 ( 523460 ) on Sunday June 11, 2023 @03:53PM (#63593650)
    Adrenalectomy sounds a bit barbaric to be termed a cure. Rather, it's palliative at best, and that's before factoring in the side effects of surgery and the loss of an adrenal gland. I'd love to see nanoparticle-based gene therapy advance to the point where it's considered a viable alternative. 5-10% of people with hypertension is a huge body of patients - something like ten million people in the US alone, so I can see this being a concern of pharma and insurers in addition to the concerned individuals.

    • What absolute nonsense you're spewing. A cure is a cure.

      Go learn the meaning of the word 'palliative'

      • I get what you are saying, but the "cure" for testicular cancer is cutting off your balls. I personally don't think that cure is much of a cure if it leaves me without balls.

  • Also Anxiety and Depression (Score:4, Interesting)

    by MikeDataLink ( 536925 ) on Sunday June 11, 2023 @03:53PM (#63593652) Homepage Journal

    If you read further aldosterone is also a big contributor to anxiety and depression disorders. Though they did not say the cure solves those problems too, I suspect it might.

     

    • "If you read further aldosterone is also a big contributor to anxiety and depression disorders. Though they did not say the cure solves those problems too, I suspect it might."

      Especially if you're depressed and anxious about your blood pressure.

    • If you read further

      Ha ha ha ha ha ha ha ha.... You must be new here. That's not how things work here.

  • 5-10% (Score:3)

    by ZipNada ( 10152669 ) on Sunday June 11, 2023 @03:53PM (#63593656)

    Almost half of the US adult population has hypertension, so 5-10% of that would be ~8-16 million people. That's a lot of operations to remove one of the adrenal glands.

    • Almost half of the US adult population has hypertension, so 5-10% of that would be ~8-16 million people. That's a lot of operations to remove one of the adrenal glands.

      Surgeons discover that more surgeries help -- film @ 11. On the other hand, if the surgery could be done inexpensively, insurance companies might be more onboard with supporting this as it might reduce other long-term treatments or conditions they've have to cover. One-time cost for long(er)-term savings ...

      The cause is a tiny benign nodule, present in one-in-twenty people with hypertension.

      How about just removing, freezing, destroying the nodule ...

      • Yeah maybe it wouldn't have to be a very invasive operation. Can probably just cauterize it off via laparoscopic surgery. Definitely a plus for the people afflicted with this.

        Now if they can just find a similar cure for the other 90-95%.

        • Yeah maybe it wouldn't have to be a very invasive operation. Can probably just cauterize it off via laparoscopic surgery. Definitely a plus for the people afflicted with this.

          Now if they can just find a similar cure for the other 90-95%.

          They have. It's called "healthy lifestyle".

      • I don't see any mention that the researchers were surgeons. But putting your sarcasm aside, if you have a piece of tissue that's causing problems and not any apparent benefit, removing it is usually a good plan and way simpler than trying to drug it out of existence. And yes, as they describe, it "could be cured by unilateral adrenalectomy — removing one of the two adrenal glands" so removing, freezing, destroying the nodule seems to work.

    • "Almost half of the US adult population has hypertension, so 5-10% of that would be ~8-16 million people. That's a lot of operations to remove one of the adrenal glands."

      Perhaps alchemists will buy them for potions?

    • I wonder if these glands could be useful for something else too. Do I really want to ditch one for this reason...

  • My 4mg dose of perindopril is my only medication. Now, I'm over 50, but just having to take that is a problem. I know why my blood pressure is elevated - a lifetime of treating my body and brain as a pair of amusement rides. But I'm really doing the work, now - I'm losing weight, I've been completely sober for a few years, and I'm generally making very healthy food choices. I see my doctor regularly, and I've been screened and evaluated thoroughly.

    But... if salt is to be my downfall, so be it. I don't drow

  • The discovery of how the gene variant affects protein CADM1 and disrupts cellular communication provides crucial insights into the challenges doctors face in diagnosing patients with this condition. The recommendation to measure aldosterone through a 24-hour urine test rather than one-off blood measurements is a crucial step toward identifying more cases of hypertension that may have gone undiagnosed. As someone who has extensively explored the topic of cause and effect on https://graduateway.com/essay-... [graduateway.com]

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